Healthcare Provider Details

I. General information

NPI: 1346740974
Provider Name (Legal Business Name): SHATANIEL M TAYLOR NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2018
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11811 SNOWBERRY DR
CYPRESS TX
77429-2893
US

IV. Provider business mailing address

8190 BARKER CYPRESS RD STE 1900-589
CYPRESS TX
77433-1223
US

V. Phone/Fax

Practice location:
  • Phone: 832-964-5198
  • Fax:
Mailing address:
  • Phone: 832-582-1068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1092647
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number924751
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: